Radiotherapy can cure cancer – but UK patients might be missing out

4 in ten patients who are cured receive radiotherapy as part of their treatment

There’s an important cancer treatment, which is widely available in the rest of Europe, that isn’t being offered to nearly as many patients in the UK as it should be.

But this isn’t an expensive new drug. We’re talking about radiotherapy – a cost-effective treatment that actually cures more patients than all the new drugs put together.

And it’s not just that the latest radiotherapy treatments aren’t available. Research published last year shows that tens of thousands of people in the UK who should be getting radiotherapy as part of their treatment, simply aren’t.

So why are patients missing out?

Radiotherapy in the UK – a brief history of neglect

Twenty years ago, on the back of a series of important scientific discoveries, there was a huge wave of excitement about the potential of a new generation of cancer drugs, which would have fewer side effects and be much more effective than traditional chemotherapy.

As a result, radiotherapy was seen as a bit of a ‘Cinderella’ – and negativity about its future role in cancer treatment led to underinvestment and subsequently a gap in the radiotherapy service across the UK, which still exists today.

It’s not all bad news, and things are improving. In recent years National Cancer Director Professor Sir Mike Richards, along with other forward-looking individuals across the UK, set out to build a world-class, country-wide radiotherapy service. We’ve now seen a much greater amount of investment in services and increases in the number of people who get radiotherapy as part of their treatment.

But there’s still much more work to be done before we can say that the UK’s radiotherapy services are truly world-class.

For example, recent research estimates that at least half of all cancer patients should be given radiotherapy as part of their treatment. But across the UK latest figures show that only around 40 per cent actually are.

Patients having radiotherapy are still waiting too long, and some new types of radiotherapy, which are available across the rest of Europe, are yet to be adopted here.

Cancer Research UK published a report last year looking at how well we’re doing in repairing our radiotherapy services. In doing so, we met with many people who are working to improve radiotherapy around the country.

The radiographers, physicists, oncologists, managers and information staff all know what’s needed to make our services among the best in Europe. But they need support and investment to ensure that new staff can be recruited, and are given time to be trained to give the most up to date treatments.

These workforce shortages, long waiting times and poor understanding of how radiotherapy has progressed over recent years has meant that some treatments like Intensity Modulated Radiotherapy (IMRT), Image Guided Radiotherapy (IGRT) and radiosurgery are still waiting to be rolled out across the UK.

Lack of awareness

Today, we’ve published a poll showing that the general public doesn’t appreciate how effective radiotherapy can be in curing cancer.

And we think this lack of awareness could be hindering the country’s radiotherapy services in three key ways:

• Firstly, we want patients to be able to make informed judgements about the treatments available to them. Raising awareness of the crucial role that radiotherapy plays in treating cancer will be important in this.

• Secondly, radiotherapy isn’t getting enough political attention because there are so few advocates among the public. Instead, pressure is constantly put on the health service to buy new cancer drugs. While these are indeed important, there needs to be more balance in how we spread our resources.

• Finally, to make our radiotherapy services world-class, we need new talent. But it’s hard to inspire people to choose a career in radiotherapy if they’ve never even heard of it.

We want UK radiotherapy services to be world class by 2020, and we believe that this can be achieved. But it will take a combined effort by the NHS, the government, and organisations like Cancer Research UK to get there.

As a first step, within five years we want to see half of all cancer patients being offered radiotherapy as part of their treatment. And we want to ensure that the radiotherapy they are offered is world class – and includes IMRT, IGRT and radiosurgery where appropriate.

That’s why Cancer Research UK is supporting the National Radiotherapy Awareness Initiative. This collaboration between the Department of Health and expert and professional groups across the UK is aiming to spread the word about radiotherapy.

The public needs to understand how radiotherapy can help treat cancer, and how new and exciting developments in this field can lead to higher cure rates.

We believe our radiotherapy services should be among the best in the world.  But we want people to better understand how important radiotherapy is so they can help us fight for this.

Hilary

Hilary Tovey is Cancer Research UK’s policy manager

Further reading:

• General information about radiotherapy from CancerHelp UK
• Highlights of our current research into radiotherapy
• Our impact in radiotherapy
• Our new radiotherapy briefsheet
• A history of radiotherapy
• MyProjects: Donate directly to a clinical trial testing radiotherapy for lung cancer

References Bentzen SM, Heeren G, Cottier B, Slotman B, Glimelius B, Lievens Y, & van den Bogaert W (2005). Towards evidence-based guidelines for radiotherapy infrastructure and staffing needs in Europe: the ESTRO QUARTS project. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 75 (3), 355-65 PMID: 16086915

Williams MV, & Drinkwater KJ (2009). Radiotherapy in England in 2007: modelled demand and audited activity. Clinical oncology (Royal College of Radiologists (Great Britain)), 21 (8), 575-90 PMID: 19651499

Delaney G, Jacob S, Featherstone C, & Barton M (2005). The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer, 104 (6), 1129-37 PMID: 16080176

Williams MV, Summers ET, Drinkwater K, & Barrett A (2007). Radiotherapy dose fractionation, access and waiting times in the countries of the UK in 2005. Clinical oncology (Royal College of Radiologists (Great Britain)), 19 (5), 273-86 PMID: 17517327